Can you give us a brief background about yourself?
I was born and raised in North Miami, FL. My father is a practicing chiropractor and inspired me to pursue a career in medicine. After graduating from Brandeis University in 1992, I sought my degree in osteopathy in light of its basis on preventive modalities and holistic slant. Veering from the traditional primary care route post-graduation, I accepted a residency position at NYU Medical Center in Neurosurgery.
Since completion of the seven-year program in 2003, I have been in private practice treating both traumatic and atraumatic conditions of the brain and spine. As a Diplomate of the American Board of Neurological Surgery (ABNS), I have been secondarily boarded in Anti-Aging and Regenerative Medicine and obtained the CSCS honorarium from the National Strength and Conditioning Association. My current practice is located in Jupiter, FL.
As a Board-Certified Neurosurgeon and author of GET SERIOUS, you have a busy daily existence. How did everything get started for you and what prompted your decision to follow these paths?
Midway through my seven-year stint at NYU, I came to realize that the majority of the diseases we as physicians were treating were, to a great degree, preventable, that the majority of diseases killing us were in fact man-made or environmental. We were not victims of bad genes, only bad choices, particularly in the context of spinal pathology. Degenerative disease of the spine, commonly referred to as “arthritis,” is one of the most common causes of workplace disability, yet its development/progression can be thwarted with modalities such as exercise, proper nutrition, stress reduction techniques and hormonal optimization. Patients were simply unaware of the fact that THEY had control, not the disease. And this is the primary underpinning of Get Serious and a main focus of my current practice. I’d rather help patients stave off surgery and live healthier lives than operate on them prematurely.
Can you tell us about your surgical business and how it compares to your Anti-Aging practice?
I currently incorporate Anti-Aging and Regenerative Medicine into my neurosurgical practice. While this may seem like an odd conglomeration of discrete medical subspecialties, to me, the hybrid format of my practice is logical. Again, and particularly as it relates to degenerative conditions of the spine, we are dealing with preventable disease processes. Even neurodegenerative diseases of the brain such as Alzheimer’s dementia have mutable risk factors such as insulin resistance or pre-diabetes. There is great overlap therefore between these diseases and in fact all age-related diseases, including cancer.
I pride myself on being able to keep “surgical” patients out of the operating room for longer than was deemed possible. How? By aggressive application of preventive or Anti-Aging modalities (aging is a disease, right?) By realizing that degenerative disease (of all types), like the aging process, stems from unchecked inflammation and oxidative stress with resultant cellular dysfunction. Accordingly most patients, barring significant neurologic deficits mandating surgery, leave my office with a prescription for NSAIDs and high-dose omega-3 fatty acids, having been encouraged to pursue an anti-inflammatory diet and daily exercise.
As an individual who lives a healthy and fit lifestyle, what does your daily diet look like?
I am for the most part an “instinctive” eater. Through much experience (over 30 years), I have come to develop a keen sense of “body-mindfulness.” I am aware of my carbohydrate sensitivity and understand how exercise, in particular strength training, modulates my day-to-day requirement for carbohydrate (one needs insulin to recover and drive muscle hypertrophy, right?). That said, on “off-days” my carbohydrate intake will typically be less than on training days. I do not count calories nor track macronutrient intake. I never step on a scale. I simply look in the mirror and monitor my performance in the gym, understanding that same is a function of my nutritional status (amongst other factors).
What does your training routine consist of? Do you do any endurance training?
Training, as outlined in the pages of Get Serious, includes all energy systems of the body. That said, Monday and Friday are geared towards strength/power and muscular hypertrophy in a classic 5x5 variant with foundations in basic anabolic movements: squat, deadlift, overhead press and bench press. Wednesday is a so-called “strength-endurance” day that taxes predominantly the oxidative-glycolytic pathways. Pull/chin-ups are performed as the staple movement. Tuesday and Thursday are endurance days of low intensity consisting of a run, swim or rowing movement at 75% target HR. Weekends are off-days to allow for ample recovery.
The program is all-inclusive. By virtue of its design, one will achieve total body fitness, inclusive of both strength and endurance. As size is a side effect of strength, well…
In addition to your diet and training, do you believe in supplements? What about specific Anti-Aging drugs? If so, which kinds do you use and what results have these given you?
There is a chapter dedicated to supplements (inclusive of medications) in Get Serious. My choice of supplements is neither random nor a product of egregious marketing tactics. Geared towards quelling inflammation, reducing oxidative stress and retarding the development of insulin resistance, all risk factors for age-related disease, the supplement list includes omega-3 fatty acids, reseveratrol, magnesium, metformin, statins and aspirin to name a few. I use every one of the listed “supplements,” and have for years. Why? They work. More recently, I have been trialing drugs such as rapamycin and valproic acid for to exploit their anti-cancer effects.
You have an absolutely world class physique. How hard is it to maintain your body-while balancing the crazy and long hours of a neurosurgeon?
All it takes is attention to detail (one of the attributes of a neurosurgeon anyway) and making health a priority. The rest follows suit. And while intermittently my sleep is compromised due to patient care issues (busy call nights, etc), I compensate by adjusting my training schedule. I have no regrets about skipping a day of training in order to avoid a potential injury (often times the result of poor recovery or a form break). In this context, every 6-12 weeks, I take a scheduled week off from training. Most of us are overtrained as you are well aware.
Talk about your book, GET SERIOUS. Go as deep as you want. Why does it appeal to every level of person interested in changing their body regardless of age?
Get Serious is a back-to-basics guide to optimal health and fitness, its foundations being strength training, nutrition, stress reduction and hormonal optimization. The information is presented in a user-friendly format and is based on 30+ years of experience. The book is not gender-specific and applies to all, young and old alike (we are all the same physiologically, right?).
Get Serious is geared toward the empowerment of the individual. The corrupt pharmaceutical industry and its “initiative” to foster disease not health serve as introduction, charging the reader to assume control of his or her health in the current healthcare environment, one relatively void of preventative thought and paradigm. Risk factors largely responsible for age-related disease are discussed as is their modification through the aforementioned modalities. The book’s appendix is a detailed layout of the training program alluded to above. The included exercises are outlined pictorially in the body of the book with an emphasis on safety and injury prevention.
As a parent and having multiple interests, how do you make time to juggle everything and also get to the gym? Where does your motivation come from in taking time to help others?
One of the main tenets of Get Serious is the prioritization of health regardless of your career, time constraints, etc. Health comes to the motivated. It is a privilege NOT a right, despite what Barak Obama tells you. No one will deliver it to you. It takes work. Execution, rooted in knowledge. The goal of the book is to empower the reader with said knowledge and encourage him/her to make the right decisions in the context of health. We’re all familiar with the “teach a man to fish…” adage. Well…
My motivation does not stem from a particular source, per se. I am constantly reminded of the perils of the healthcare “system” during stints in the ER however. Called to see a patient with a hypertensive hemorrhage in the brain, I simply don’t want to be that guy lying on the gurney. I do everything in my power therefore to prevent age-related disease. Or maybe, at a more base level, I’m on a personal quest for continued improvement. I’ve always been fascinated by older individuals (if that truly means something) who possess the physical and mental capabilities of those half their age.
As a physician, what advice would you give someone (at any age) who wants to transition towards a more healthy and fit lifestyle but doesn’t know where to start?
Start immediately. My chairman at NYU used to say, “You’re never too old for good health.”
The first step is education. Read everything you can in the context of health. Speak to people. Ask questions. And then execute. Habits are formed within 4-6 weeks. And never give up. Physical changes are slow but metabolic changes occur relatively quickly (in parallel to the reduction of risk for age-related disease). Keep in mind that health is a lifestyle. You are not training for a specific event, per se; you are training for a lifetime of health and longevity.
What is next for you? What are your future plans and goals? Do you think you might compete in a Masters Men’s Fitness Competition?
I aspire to further extend the reach of my Anti-Aging practice to include a training facility. Patients will undergo robust risk factor screenings to include cardiovascular assessments, metabolic and endocrine assays, cognitive testing, body fat analysis and exercise tolerance to name a few. A personalized treatment plan with heavy emphasis on patient education (and understanding of the diagnosed risk factors) will be developed and prescribed. Patients will be held accountable through frequent visits both to the clinic and the training facility. Biochemical and performance data will be analyzed and tracked and by virtue, we will assure success.
At this point, I have no desire to compete in a Men’s Fitness Competition. The vast majority of these contests are being won by individuals on synthetic hormones or growth factors (despite the “natural” claims) and I simply am not interested in exposing myself to the potential risks. This is about health after all. What people fail to realize is the stark difference between looking healthy and being healthy. Bodybuilders have some very unhealthy habits, remember. I always tell people that, "The look is a side effect of the lifestyle, not the other way around."